Drug - Viibryd (vilazodone) [Forest]
February 2013
Therapeutic area - Antidepressant
Selective Serotonin Reuptake Inhibitors
Preferred | Nonpreferred |
citalopram
escitalopram |
Celexa |
fluoxetine | Lexapro
Paxil/Paxil CR |
paroxetine | Prozac |
Pexeva | Fluoxetine DR (weekly) |
Prozac Weekly | |
sertraline | paroxetine suspension |
Sarafem | |
Viibryd * | |
Zoloft
|
|
* individual PA criteria apply |
New Generation Antidepressants
Preferred | Nonpreferred |
bupropion IR, SA, XL | Aplenzin* (bupropion HBr) |
fluvoxamine | Cymbalta |
mirtazapine | Desyrel |
nefazodone | Effexor, Effexor XR |
trazodone | Luvox CR * |
venlafaxine extended release | Prestiq * |
venlafaxine extend release capsules (generic EffexorXR) | Remeron |
venlafaxine extended release | Wellbutrin/ SR / XL |
tablets (generic) | |
* individual PA criteria apply |
Metabolism by CYP3A4 is a major elimination pathway for vilazodone. Patients must start Viibryd using the Patient Starter Kit or the 40 mg dose. If the prescriber is requesting 10 mg or 20 mg strengths, documentation that Viibryd is being used for maintenance therapy and is being co-administered with a strong inhibitor of CYP3A4.
Viibryd (vilazodone) is a selective serotonin reuptake inhibitor (SSRI) and a serotonin (5-HT1A) receptor partial agonist indicated for the treatment of major depressive disorder (MDD) in adults. Vilazodone is titrated to the recommended dose of 40 mg once daily with food. There are many other drugs indicated in the initial treatment of MDD including: tricyclic antidepressants (TCAs), SSRIs, SNRIs, bupropion and mirtazapine.
The most recent guidelines published by Kaiser Permanente Care Management Institute in 2006 for the treatment of depression in primary care recommend SSRIs, TCAs, serotonin norepinephrine reuptake inhibitors SNRIs, and dopamine agonists as first-line treatment of MDD. The preference of antidepressant is based on patient’s history with drug treatment, clinician choice, adverse effects, among other factors. Vilazodone is the first FDA approved antidepressant with a dual serotonergic mechanism of action acting as both a SSRI and a partial serotonergic agonist. There are no clinical trials comparing the efficacy or safety of vilazodone to other antidepressants. It is not clear if vilazodone offers any unique efficacy or safety advantage over existing therapies.
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